Abstract Background There is currently a significant waiting time for patients referred to the IBD infusion unit to start new biologic therapies at St Marks Hospital, due to capacity issues. To address this challenge, this study proposes a new infusion administration regimen with shortened infusion times; patients will be administered their first infliximab dose over 2 hours, doses 2-3 will be administered over 1 hour, and any subsequent doses will be administered over 30 minutes. Methods Suitable patients were identified by the IBD pharmacy and nursing teams prior to infliximab initiation. Patients with previous exposure to infliximab and/or any history of cardiac disease or on escalated doses (10mg/kg) were excluded from this study. Safety protocols were in place in the event of any infusion-related reactions. Details were recorded of infusion times, occurrence of any infusion reactions and interventions or treatments provided. Results Data was collected for a total of 37 patients. At the time of reporting, 26 patients had at least three doses at the proposed infusion regimen and did not experience any infusion-related reactions. When compared with the licensed administration schedule (first three doses over 2 hours and subsequent doses may be given over 1 hour)1, this new regimen resulted in a total administration time saving of approximately 50 hours. In addition, four patients subsequently received a fourth dose at an infusion rate of 30 minutes with no infusion-related reactions, which resulted in an additional 2 hours of administration time saved. A further 17 patients were transitioned to subcutaneous infliximab after completing three intravenous doses. Three patients (8.1%) developed an infusion related reaction after their second dose. Two of these patients had previous exposure to infliximab which was not identified prior to initiation and should have been excluded from this study. Overall, our results show similar rates of infusion-related reactions to those reported in the literature. In phase III studies, 18% of patients experienced an infliximab-related reaction1. In another study for Crohn’s disease patients, 16.6% of patients treated with infliximab monotherapy and 5% of patients treated with infliximab and azathioprine combination therapy experienced an infusion-related reaction2. Conclusion Our results suggest that the proposed infusion regimen does not increase the risk of infliximab infusion-related reactions when compared with the standard licensed administration schedule. Adopting this regimen could significantly enhance infusion unit efficiency by reducing administration time burden, which may subsequently reduce wait times for patients requiring initiation of biologic therapy. References: 1. Remsima 100 mg powder for concentrate for solution for infusion - Summary of Product Characteristics (SmPC) - (emc). Last accessed: 17/11/2025. https://www.medicines.org.uk/emc/product/3709/smpc 2. Colombel JF, Sandborn WJ, Reinisch W, et al. Infliximab, azathioprine, or combination therapy for Crohn’s disease. New England Journal of Medicine. 2010;362(15):1383-1395. doi:10.1056/nejmoa0904492 Conflict of interest: Mr. Shaaban, Ali: No conflict of interest Chana, Angela: No conflict of interest Younge, Lisa: Personal Fees: Abbvie, Takeda, Jannsen, Ferring Pharm Tyrrell, Tracey: No conflict of interest Rejee, Christy: No conflicts
Shaaban et al. (Thu,) studied this question.
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